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Horm Cancer. 2019 Dec;10(4-6):161-167. doi: 10.1007/s12672-019-00367-0. Epub 2019 Aug 29.

Metastatic Adrenocortical Carcinoma: a Single Institutional Experience.

Author information

1
Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, 320W 10th Ave, Columbus, OH, 43210, USA.
2
Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, 1800 Cannon Drive, Columbus, OH, 43210, USA.
3
Division of Surgical Oncology, Department of Surgery, The Ohio State University, 410 W 10th Ave, Columbus, OH, 43210, USA.
4
Division of Endocrinology, Diabetes & Metabolism, Department of Internal Medicine, The Ohio State University, 320 W 10th Ave, Columbus, OH, 43210, USA.
5
Department of Surgery, West Virginia University Cancer Institute, 1 Medical Center Drive, Morgantown, WV, 26506, USA.
6
Division of Human Genetics, Department of Internal Medicine, The Ohio State University, 320 W 10th Ave, Columbus, OH, 43210, USA.
7
Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, 320W 10th Ave, Columbus, OH, 43210, USA. bhavana.konda@osumc.edu.

Abstract

Adrenocortical carcinoma (ACC) is a rare malignancy with limited data to guide the management of metastatic disease. The optimal treatment strategies and outcomes of patients with metastatic ACC remain areas of active interest. We retrospectively reviewed patients with ACC who were treated with systemic therapy between January 1997 and October 2016 at The Ohio State University Comprehensive Cancer Center. Kaplan-Meier and Cox proportional hazards regression models were used for survival analysis. We identified 65 patients diagnosed with ACC during the given time period, and 36 patients received systemic therapy for distant metastatic disease. Median age at diagnosis was 50 (range 28-87). Median overall survival (OS) from time of diagnosis of ACC was 27 months (95% CI 19.6-39.3), and median OS from time of systemic treatment for metastatic disease was 18.7 months (95% CI 9.3-26.0). Clinical characteristics at time of initiation of systemic therapy were assessed, and presence of bone metastases (p = 0.66), ascites (p = 0.19), lung metastases (p = 0.12), liver metastases (p = 0.47), as well as hormonal activity of tumor (p = 0.19), were not prognostic for survival. Six patients with liver metastases treated with systemic therapy who received liver-directed therapy with either transarterial chemoembolization (TACE) or selective internal radiation therapy (SIRT) had longer survival than those who did not (p = 0.011). Our data expands the knowledge of clinical characteristics and outcomes of patients with ACC and suggests a possible role for incorporating liver-directed therapies for patients with hepatic metastases.

KEYWORDS:

Adrenal cortical carcinoma (ACC); Chemotherapy; Selective internal radiation therapy (SIRT); Trans-arterial chemoembolization (TACE)

PMID:
31468469
DOI:
10.1007/s12672-019-00367-0

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